Endocrine Abstracts

Amongst the different markers of ovarian function, AMH levels and antral follicle count (AFC) are the most objective and reliable predictors of ovarian response in women undergoing in-vitro fertilisation (IVF). Several factors, that have been reported to interfere with ovarian response, are taken into consideration when enrolling women into an IVF programme.

The aim of this prospective study was to determine the correlation, if any, between baseline AMH levels and AFC with lifestyle factors (smoking, BMI >19<30 Kg/m², alcohol consumption), demographics (ethnicity, age) and reproductive history (age of menarche, years since menarche, gravidity).

A total of 136 consecutive women undergoing hormonal and ultrasound assessment before starting their first IVF cycle were recruited. The inclusion criteria were: first ever ovarian stimulation cycle; regular menstrual cycles; age < 40 years; both ovaries present; no family history of premature ovarian failure; no history of autoimmune disorders; no current hormone therapy. The number of years since menarche was calculated as age minus the age of menarche. On day-3 of a spontaneous menstrual cycle, all subjects had measurement of plasma AMH levels and a transvaginal ultrasound scan for AFC (2–5 mm in diameter). The data were transferred in to StatsDirect and statistical analysis tests were used as appropriate. Ethical approval for this study was obtained from the LREC.

A strong correlation was found between AMH and AFC (r_s=0.54, P<0.0001). AMH levels and AFC both correlated negatively with age (r_s=−0.30, P<0.0005 and r_s=−0.27, P<0.0013, respectively) and number of years since menarche (r_s=−0.23, P<0.0073 and r_s=−0.21, P<0.015, respectively). There was no correlation with smoking, BMI, alcohol, ethnicity, age of menarche and gravidity.

Plasma AMH levels and AFC correlated negatively with age and number of years since menarche, but not with any other variable considered in the study. Age and number of years since menarche should therefore be considered as a useful adjunct to AMH and AFC when estimating ovarian reserve. The effect of lifestyle factors on ovarian performance remains to be established.